Cardiac Arrest Caused by Nafamostat Mesilate

Abstract A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding...

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Published in:Kidney research and clinical practice 2016, 35(3), , pp.187-189
Main Authors: Kim, Hyo Shik, M.D, Lee, Kyung Eun, M.D, Oh, Ji Hyun, M.D, Jung, Chan Sung, M.D, Choi, Dughyun, M.D, Kim, Yunsuek, M.D, Jeon, Jin Seok, M.D, Han, Dong Cheol, M.D, Noh, Hyunjin, M.D
Format: Article
Language:English
Subjects:
Anaphylactic shock
Cardiac arrest
Case Report
Nafamostat mesilate
Nephrology
내과학
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Summary:Abstract A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit (ICU) for five days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the ICU. Conventional hemodialysis was reinitiated, and nafamostat mesilate was used again due to a small amount of continued bleeding. Ten minutes after hemodialysis, the patient complained of anaphylactic signs and symptoms such as dyspnea, hypotension and facial swelling. Epinephrine, dexamethasone, and pheniramin were injected under the suspicion of anaphylactic shock, and the patient recovered. Total immunoglobulin E titer was high and skin prick test revealed weak positivity for nafamostat mesilate.
ISSN:2211-9132
2211-9140
DOI:10.1016/j.krcp.2015.10.003